Previous literature suggests that AIDS Service Organizations (ASOs) play an important support role in the lives of impoverished women living with HIV. Less is known about the dynamics of institutional support for middle-class women living with HIV/AIDS, who are assumed to possess a broader base of resources to address their diagnosis. Using qualitative data collected from a racially and economically diverse group of HIV-positive women in Chicago, this article compares how low-income and middle-class women utilize ASOs and reveals how the women’s divergent approaches to availing themselves of institutional resources have important implications for their social and economic coping. While impoverished women frequently use HIV-specific institutional ties to establish economic stability post-diagnosis, middle-class women do not experience similar economic gains through these kinds of ties. Associating with ASOs has different implications for women’s class-based social standing, with it being status-improving for impoverished women and status-diminishing for middle-class women. As a result, middle-class women report a less robust network of social service providers and people living with HIV/AIDS on whom they rely for HIV-related information and social support, making them vulnerable to HIV-specific social isolation. In sum, the ways that HIV-positive women deploy institutional ties to negotiate their HIV/AIDS status differs markedly depending on socioeconomic status, suggesting that their pathways for gathering social support may be more complex than previously understood.